Saturday, January 30, 2010

The faces of stuttering

My name is Peter Louw. I am an ex-patient and unashamed admirer of Dr Martin F Schwartz, of the National Center for Stuttering in New York (www.stuttering.com) who believes that stuttering is the learned result of the vocal folds' hypersensitivity to stress in 1 - 2% of people. Maybe he, too, is a crackpot, but I have been doing his Passive Airflow Technique for 30 years and it has helped me much. Presently I am developing a blog on this issue at http://stuttersense.blogspot.com. Looking forward to more of your stimulating blogs. Keep up the good work!

17 comments:

"...stuttering is the learned result of the vocal folds' hypersensitivity to stress in 1 - 2% of people."

Not sure I understand what that means. If the vocal folds of stutterers are different from those of non-stutterers, then you should be able to show the difference. Has anyone done so? The mere fact that the vocal folds operate differently during stuttering than during fluent speech doesn't tell you anything.

Dr Martin Schwartz has done a lot of work on this, you can check out his Center's site at www.stuttering.com There is a video and his latest book is on the site for free. It's true that he is controversial, but that's a good thing, it stimulates thinking. Regards, Peter

I see you refer to the Stutt-L "discussions" with Dr Schwartz in the 90s. I am so sorry that I wasn't a member of that newsgroup at the time - I would certainly have given another side of the story.

I found the tone and nature of that discussion quite vicious, with an apparent agenda behind it all. The same happened with the interrogation of the McGuire Programme on Stutt-L. I don't quite agree with McGuire's theory but many people have obviously been helped by him. My impression is that as soon as someone is making some progress with treating stutterers, some conservative therapists respond viciously and do everything in their power to shoot him down. That's one reason why the stuttering scene remains in the dismal state it is today. Yes, indeed, the crackpots should be exposed, but don't throw the baby out with the bath water.

Instead of always referring to the Stutt-L ambush (which Dr Schwartz didn't respond to), why don't his opponents refer to the fact that, despite the hysterical opposition against vocal fold therapy in the beginning, more and more individual clinicians as well as institutes /clinics apply vocal fold therapy for stuttering? The City Lit in London uses vocal fold therapy, so do at least two other institutes in the US, one of them being Dr Schwartz's NCS. Slowly this line of thinking is making progress - 30 or 40 years after it first became known. Who knows where we might have been today had it not been for the professional, reactionary jealousy of Dr Schwartz's initial opponents?

I think he wants to make money from this, but his theory is very true and logical. Stuttering is nothing but learned behavior, a sticking of the vocal chords. Like a whistle: you have relax and to put an air through, to make a noise. Then, when the first wave of air has passed through (and with it the first syllable of the sentence), and after that you make a pause of 0.5 sec (all that in the same exhale), you can say the rest of the sentence.But, at the beginning, this can be only implement in the most relaxed zone, when you are all alone, or with the closest one. Also, this is really hard to implement in the real life. It seek a lot of effort. I am practicing this for a half a year, and it helped me a lot in the speech. But, if you don't have the will, don't even try

Peter, I don't want to get into a long discussion about Schwartz. Fortunately he is no longer doing workshops and his "therapy" is on its way out. But the fact is that many have been deeply hurt by this man and he has caused alot of damage in our community. If you are at all involved in the stuttering community than you would know this.

I am glad he was able to help you. But I would urge you to look at the whole picture and not just at your own experience.

I have no experience with the passive air flow technique, but I think there's a sound theory to back it up. The exhalation guarantees that the vocal folds are opened and ready to close for phonation, rather than tightly closed and unable to open.

My main problem with it is that blocks can also happen in other places. What are the components of speech? Respiration, phonation and articulation. Any of these are vulnerable to stuttering blocks. The diaphragm can freeze in a conflict between inhalation and exhalation. The vocal folds can get stuck in a tightly closed position, as Dr Schwartz and others have observed. The lips can also freeze in a closed position on certain speech sounds. So while the air flow technique may help us deal with one kind of block, there are other kinds of blocks to look out for as well.

Schwartz is however not the only one to note that a brief exhalation before speaking helps. Many of us find this effect on our own (it's a common trick to begin speaking on the last exhalation). It's also interesting to note that "deep and breathy tone" is also on the McGuire checklist. I've never heard anyone explaining the breathy part in detail, but I'd guess it's in effect what Schwartz proposes.

One man, called Andrew Greenstein completely overcomed stuttering few years ago, using the modified technique by Dr.Schwartz. He explained the technique at www.stutteringforum.com.

Here are some of his explanations:

"OK, if your stuttering occurs at the beginning of sentences alot:

1. Prior to speaking, feel what it's like to NOT intend to speak at all.. just REST... as you breathe in normally [not breathing as a technique, just the regular breathing you do all day long]--- begin thinking of rest..relaxation..you're not speaking, you're standing there...as you exhale naturally, you're still thinking rest.. then, as an after thought..on that SAME* exhalation

2. begin speaking--intending to only say ONE syllable... there should be a definite comma after it..say it gently.. like this:My name is John becomes[rest, rest] My, name is john

--3. Once you've said the first syllable "my"--gently/by itself--you can say the rest of the sentence naturally...as an AFTERTHOUGHT..

4. When you run out of air and NEED another breath..remember that exhalation--you should be taking another "time out" from speaking-- intending only to rest/relax--and then--the next fist syllable is slowed again.

5. Intending to speak while breathing out..forming words before they start, saying the first syllable hard, fast --or co-articulating it w/ the second syllable [letting the start of the second syllable be influenced by the end of the first syllable or vice versa]]] are all little mistakes--that R common--but that can still lead to stuttering when you're scanning words.

Doing this 100% correctly--renders blocking a physical impossibility BUT it is not usually that eays to do it correctly--without INTENSE,long-term practice..

So, lesson #1-- is NOT being fluent in the real world.. Lesson #1--is getting to the point where you can do this successfully in an EASY setting; one where you might not stutter anyway.. For the next week, spend 20-25 min in the morning and another 20-25 min in the evening-- READING sections of books or magazine articles..using this technique.. tape yourself and/or have someone there LISTENING To you--someone to whom you've explained the technique-- Their job is to MONITOR to you--to tell you when you miss one-- when you take a breath or start a sentence w/out proper technique-- PLay it like a GAME-- like a sport.. It's a challenge..but it can become easy-- See if, after 1 week, you can read anything/anytime-- w/ this technique.. The idea is to be able to play the BASIC sport against amateurs BEFORE you can play in the major arena.. Learn to play chopsticks on the piano before performing Beethoven's 5th in concert.. The reading at hoem is learning chopsticks-- Fluency in a "real life" conversation is Beethoven's 5th.. It will be a few weeks before we get up to real conversation..

"1. multisyllable words can be hyphenated likeun-for-tun-ate-ly-- if you've ever seen my videos, you see how NATURALLY this can be done [like you're thinking]-- and should said gently/softly..HOWEVER, in the beginning-and when tension is especially high, you will SUBTRACT more tension by sayign the FIRST syllable by itself as though it's all you are going to say

2. Re: mid sentence-- a lot of stuttering--adult stuttering is mid sentence [where a sentence is measured between breaths/ not grammatically]---was the same for me.. If done correctly, you cannot stutter mid sentence... I can give you a more detailed explaantion of why-- but it's going to attract too much "icky" attention on this board..been there, done that-- If you want me very clearly explain why you will not stutter mid-sentence [if you start your sentence correctly, please call me ]--- But be careful, if you see a feared word coming up, you might inadvertently take a new breath... this means you need to reapply technique.. each new breath must = technique or you CAN Stutter.... Eventualyl, your sub-c will become trained to sync breathing w/ technique w/ little or no concious involvmeent-- but first you need to evolve successfully through the practice exercises... ALSO, if you "see" a word coming up midsentence, it will usually be MULTIsyllable [not always ,but usually]--- pretend you are only going to say the first syllable.. i.e. instead of thinking "I'd like to order a large pizza"-- if PIZZA is the feared word, think "I'd, like to order a large PI [pee]"--I know you normally block on the "P"--buit there are brain/vocal reasons why you will not block if you think PI instead of PIZZA -- I can also explain"

The whole thread is here:http://stutteringforum.com/forums/showthread.php?t=2121

Also there are much more explanations from this man, you can see his posts on his public profile

It is such a pity that when discussing Schwartz or his work, some people respond with ad hominem (personal) attacks instead of discussing his ideas.

You write: "Fortunately he is no longer doing workshops and his "therapy" is on its way out."

I have bad news for you. He is indeed in semi-retirement I believe, being in his seventies, but in the course of his career he has trained hundreds of therapists in his approach. As mentioned, some clinics and institutes are also now offering vocal fold therapy. So his work will be carried forward. It means that the reactionary establishment agenda has failed.

You write: "But the fact is that many have been deeply hurt by this man and he has caused a lot of damage in our community."

All therapists have their therapy failures, and Schwartz is no exception. Particularly in the beginning he was probably over-enthusiastic (in his last book he actually mentioned that he was rather naive when younger). Vocal fold therapy is not a miracle cure and in fact requires much energy, time and perseverance. But if he has indeed pinpointed the cause of stuttering, it surely is a huge step forward? If consensus can be reached on the cause, all the research energy can be focused towards improved ways of dealing with our troublesome vocal folds.

"I am curious, do you think his 90% plus success rates are accurate?"

As I understand his claims, he is saying that 90% of people who HAVE DONE ALL THEY ARE SUPPOSED TO DO IN THE PROGRAMME do benefit. That means that they have to do daily practising, regularly phone other participants, appoint a "monitor" to evaluate their application of the technique, do stress management etc. It means that about 10% of people do not benefit even though they have done all that is required. These are severe stutterers, and it's an unfortunate fact that some people do not benefit from any therapy whatsoever. Note however that Schwartz's criteria for "severity" differ from that of many other therapists. I have no reason to think that his results are inaccurate. This 90% is not "cured", but manage their stuttering to some extent via vocal fold management combined with stress control. Regards, Peter Louw

These classic stuttering speech therepy technique are so difficult in a stressful situation it's like lifting a 10 lb weight with your pinky finger. They also sound awkward and demented. So now both have a stutter and a demented speaking tone/rate. Though I agree not to give up and have hope. Sort of like religion. A lie can go a long way.

Peter, thanks for your response. By all means let's discuss Schwartz's theories and therapies. Could you show us the independent research that supports his theory on the cause of stuttering? Could you point us to the researchers who believe in his theory. Also, could you point us to the independent research that supports his success rates? Thanks in advance.

I think we need to distinguish between the methods used for treatment and the theory behind.

I have read his book when I was a student 15 years ago, and the theory is clearly out-of-date, and wrong. In fact, it is very much a naive theory. And with the latest findings, if he insists on his theory, he is behaving like a crackpot.

The experience could well have helped Peter and if that is his experience, he is free to communicate it to us. However, Peter, I am wondering very loud whether you could not have made similar experiences with other treatments. We will never know, but I would not be surprised.

Finally, good of him to have made his face public. He has courage and I encourage everyone to do the same!

Largely retired, I have been devoting my activities to investigating the role of vitamin B1 (thiamin) and stuttering. For those interested, I refer you to a study http://www.stuttering.com/research.html which explains the protocol in detail. Several other investigators are currently attempting to replicate the findings. An informal survey of those following the suggestions in the study have also obtained similar results (see the blog, stuttersense).